Despite recent advances, neurological diseases continue to be a major public health problem and are the source of significant morbidity and mortality not only in the United States, but world-wide. With the explosion of new knowledge in the neurosciences, the possibility of dramatic reductions in the overall neurological disease burden exists, but translation of new laboratory findings into new human treatments has lagged partially due to inefficiencies in the organization, funding, and execution of the necessary human clinical trials to prove the efficacy of new therapeutic approaches. This renewal for the Network for Excellence in Neuroscience Clinical Trials (NeuroNEXT) is proposed to help expedite the process of the conduct of early phase multi-center clinical trials to establish safety and dose information or to validate biomarkers and clinical outcomes in preparation for middle and late phase trials of efficacy. This application proposes the University of Virginia Health System be renewed as a Clinical Site for the NeuroNEXT network. The proposal describes the effective and efficient past performance of the University of Virginia as a NeuroNEXT site, the extraordinary experience and expertise of a multi-disciplinary cadre of clinical neurological investigators available to conduct NeuroNEXT trials, an already existing clinical outreach program that will afford access to rural minority and medically underserved patient populations, an outreach program with statewide neurology practices that will maximize trial recruitment throughout the catchment of the University of Virginia, the research infrastructure and leadership plan for successfully executing NeuroNEXT clinical trials at the University of Virginia, and our robust history and further plans to mentor future clinical researchers.